What is online therapy?
The Health Resources and Services Administration’s website defines online therapy, also known as “telehealth,” as “the use of electronic information and telecommunications technologies to support long-distance clinical healthcare, patient and professional health.”
Telehealth, or online therapy, can be conducted via video conferencing, which typically involves a mental health professional evaluating and providing psychotherapy to a client via live, two-way, interactive audio/video connection.
Online therapy goes by many names, such as “online counseling,” “web therapy,” “distance counseling,” “telemental health,” “cybercounseling,” and “behavioral telehealth.”
Online therapy is not intended to replace traditional face-to-face therapy, but it can be a better fit for many people.
Benefits of online therapy
Online therapy can be beneficial for treating many symptoms and can help remove barriers such as stigma and geographical distance. It can minimize costs such as gas, tolls, parking and childcare. This can be most useful for:
- Parents with children where childcare is a challenge
- People who struggle with chronic pain or those with accessibility needs
- People who struggle with leaving the house, as in cases of agoraphobia
- People in remote locations
- Individuals who are hearing impaired
- College students who prefer to stay on campus or in their dorm room
Online therapy can also be useful for people who simply don’t want to leave the house.
Who wants to spend more time in a car or on public transport?
The American Psychological Association notes,
“Online communication is very comfortable for many people, especially younger adults or those who use technology often. More people are using email, webinars and text messaging to communicate, and it can seem more comfortable or easier than talking to someone in person, especially when revealing personal or private information.”
One important piece to keep in mind is that you must reside in the state of California at the time of treatment to work with a California state licensed mental health professional.
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How does online therapy differ from face-to-face therapy?
One drawback to online therapy is that there is a limit to how much can be viewed on the screen. Somatic cues can be missed, such as leg activity and some gestures.
A good therapist will be cueing you to feel into what is happening for you, body-wise. A strong internet connection can provide clarity in moment-to-moment facial expression, and your therapist can see you just the same, if even closer than in-person treatment.
Some studies show that the face-to-face connection mimics the closeness that a baby feels when being held closely by the mother.
Given the internet connection, you may experience a freezing of the screen at times. To boost bandwidth, it can be helpful to close out any open windows on your screen, so that only the video connection remains. Also, plugging directly into an ethernet cable can maximize a strong virtual connection.
An intuitive therapist can sense the “air” of a client even with the digital connection. While the two of you are not in the same energetic space, you should feel seen, heard and understood as much as in traditional face-to-face therapy. In some cases, eye-to-eye contact can even be simulated.
It is important to tell your therapist when you feel something has been missed, as when they can’t read the emotion emerging from your eyes. Giving honest feedback to your therapist on what worked and what didn’t can help smooth out any disconnection.
The shortcomings of the internet are par for the course, and the benefits can outweigh the cost in terms of convenience and accessibility.
Internet security and confidentiality
Confidentiality is just as important in online therapy as it is in more traditional forms of treatment delivery. HIPPA-compliant platforms, such as doxy.me, which was developed by a doctor (as in “the doc will see me”) ensure the video connection is encrypted so you can feel safe that what you are discussing stays between you and your therapist.
Doxy.me also requires no download and simply places you in a virtual waiting room where your therapist then comes to ‘meet’ you.
Some clients find that with online therapy, they are able to access deeper material given they are in the comfort of their own home.
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Is online therapy reimbursable through my insurance?
One thing to note is that some insurance companies will not cover online therapy.
This can depend upon the insurance that you have. It is important to check prior to your initial appointment. When you contact your insurance carrier to check, make sure to share the relevant CPT code: 90834-95 for individual therapy, and 90847-95 for couples or family therapy.
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What does the research show about online therapy?
Overall, studies show that online therapy can be as effective as traditional in-person treatment. In a study titled “A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions,”
Azy Bark states, “The findings of this meta-analysis, and review of additional Internet therapy studies not included in the meta-analysis, provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity and suggest several insights in regard to its application.”
“You’ll never be bored when you try something new.” – Dr. Seuss
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Online Therapy at Well Clinic in San Francisco
If you are interested in learning further whether online therapy is for you, Well Clinic offers free 15-minute consultations with trained mental health professionals who offer psychotherapy via HIPPA-compliant video conferencing software.
Some therapists who offer this service here at Well Clinic (some of whom require one or more in-person sessions to begin) are:
Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N (2008). A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions, Journal of Technology in Human Services, 26(2-4), 109-160.